Corrective Action Request - Magnetek

Short Term Corrective Action: Assigned to: Due by:
(Describe what steps were or will be taken to prevent recurrence of the problem pending the implementation
of Long Term Corrective Action.)
Initiated by : Date: Forward form to Quality Assurance
Long Term Corrective Action: Assigned to: Due by:
(Describe what steps were or will be taken to permanently fix the problem, and steps to prevent this and other
similar potential problems.)
Initiated by: Date: Forward form to Quality Assurance
Verification of results : Assigned to: Due by:
(Describe what measures or checks were performed to demonstrate that the actions were effective.)
Checked by: Date: Forward form to Quality Assurance
Next section to be completed by Magnetek PCS (when Fault Log is not Used)
Correction confirmed by:
Follow­up required: Ž Yes Ž No
Date:
If yes, provide date:
Magnetek PCS: Title: Date:
Distribution: Pending and completed forms are filed in the Purchasing Department. Copies are distributed to other departments as needed.
Closed and filed, or Reissued
Page 2 of 2 F­CAR ,Rev. C, 04/06/2006